The impact of mammographic imaging systems on density measurement

The purpose of this study is to investigate whether having a mammogram on differing manufacturer equipment will affect a woman's breast density (BD) measurement. The data set comprised of 40 cases, each containing a combined image of the left craniocaudal (LCC) and left mediolateral oblique (LMLO). These images were obtained from 20 women age between 42-89 years. The images were acquired on two imaging systems (GE and Hologic) one year apart. Volumetric BD was assessed by using Volpara Density Grade (VDG) and average BD% (AvBD%). Twenty American Board of Radiology (ABR) examiners assessed the same images using the BIRADS BD scale 1-4. Statistical comparisons were performed on the means using Mann-Whitney, on correlation using Spearman's rank coefficient of correlation and agreement using Cohen's Kappa. The absolute median BIRADS difference between GE and Hologic was 0.225 (2.00 versus 2.00; p<0.043). The VDG measures for GE was not statistically different to Hologic (2.00 versus 2.00; p<0.877), likewise the median AvBD% for the GE and Hologic systems showed no difference (6.51 versus 6.79; p<0.935). BIRADS for GE and Hologic systems showed strong positive correlation (ρ=0.904; p<0.001), while the VDG (ρ=0.978; p<0.001) and AvBD% (ρ=0.973; p<0.001) showed very strong positive correlations. There was a substantial agreement between GE and Hologic systems for BIRADS density shown with Cohen's Kappa (κ=0.692; p<0.001), however the systems demonstrated an almost perfect agreement for VDG (κ=0.933; p<0.001).